A National Veterinary Journal used my dog’s struggle with bone cancer as their front page lead story for the January 2016 issue. I’m proud and humbled, but have a huge lump in my throat. I know many of you have dogs afflicted by cancer. You see by this story – I understand! You can read their on-line story here:
Or the simpler version is published for you here: ~ Dr. Humphries
The Pain of Canine Osteosarcoma
One Veterinarian’s Personal Story
Canine osteosarcoma hit me very personally on July 22, 2014. That was the day my wife pointed out a slight swelling on the end of the left radius (front arm long bone) of my beloved Great Dane. My heart sunk instantly when I saw it. I immediately feared that this was osteosarcoma (OSA).
Taylor Dane, as we named her, came into our lives eight years earlier as a beautiful 7 month old from Great Dane Rescue. Her original owners had relegating her to a lonely existence, isolated in their backyard. Having spent her early, important socialization months isolated from new people and pets, she was terrified. At first, we had to keep a “house leash” on her, even indoors, just to be able to get hold of her. But as fear turned to trust, Taylor took over our house … and my heart.
I have had many dogs since childhood, dogs that I have loved dearly; but never had I experienced the depth of connection that I would have with Taylor. A tall and elegant, fawn female, Taylor had a personality as big as her body. She was wonderfully exuberant, completely affectionate and very “large-and-in-charge”. She would stare into my eyes as if she was trying to memorize my face and seriously communicate. This relationship was something special and it quickly grew deep, for both of us.
So imagine how it felt when the radiographs confirmed my worst fear, Taylor indeed had osteosarcoma and, without showing a single sign of pain or lameness, the tumor had already encompassed three-fourths of the circumference of the radius.
We are very fortunate to live near the Flint Cancer Center at CSU in Fort Collins, CO, so I took Taylor there as quickly as possible to discuss treatment options. After long discussions with several specialists, the decision was made to attempt a limb spare procedure. On the first of August, the distal two-thirds of her radius was removed and replaced with cadaver bone. An equine plate was used for fixation since even the longest canine plate was too short.
Taylor did very well with surgery, and as would be true throughout her many treatments, she handled everything we asked of her with a quiet dignity. She would lay quietly for her twice a day bandage changes. She began chemotherapy, receiving four treatments of Carboplatin three weeks apart. She healed from her surgery and learned to use her “new” leg. It helped tremendously that my wife is a physical therapist. She did Taylor’s bandage changes and daily physical therapy with her. Taylor took it all in stride and soon mastered running up and down the hills of our horse farm. She learned to climb up and down the stairs and even returned to jumping up to join us in bed, as much as we tried to prevent it. Our girl was back; as happy and active as ever.
Because infection is the greatest problem with limb spare cases, Taylor remained on high doses of antibiotics. But still, within months she began to show signs of infection in the lower part of this leg. Cultures revealed a tough MRSI infection and even with targeted therapy, it eventually went to the bone and caused the fixation screws to lose purchase. We faced an agonizing decision. My wife and I felt strongly that Taylor would not do well with a front leg amputation. As an almost 9 year old giant breed who lived on a very hilly property, we were greatly concerned that her remaining front leg would quickly begin to break down. She also had two large, exuberant Dane buddies whose play was a constant challenge to her balance. However, we decided to amputate, knowing we could fit her with a prosthesis.
As anyone who has gone through it can attest, the home post-op care of an amputation requires a great deal of time and commitment. Taylor went through the endless bandage changes and learning to get up and down and walk on three legs with a gentle, cooperative spirit. Because she was so large, she wore a special harness to allow us to help her get up on her feet. Our house sits at the top of a hill with the ground dropping off on all sides; there is very little level ground. This produced great challenges to Taylor as she became accustomed to being a tripod. This was the roughest time; but after about three weeks, she was ready to fit for a prosthesis.
Taylor received her prosthesis on March 12th. She didn’t immediately use it, however. She would hold it in the air and stand and walk on three legs. It took twice daily work over many weeks to teach Taylor how to first put weight on her prosthesis and then how to move in it. It made such a difference when she learned simply to stand with weight on it. She could now stand comfortably and for as long as she wanted; no more trying to balance on three legs. She could also sit again now that she could put weight on both her front “legs”.
With a lot of patience and training, Taylor started going for walks around the property with her people and her two Dane buddies. Eventually, she was running up and down the hills and accompanying us on walks to the pond. She even learned to ride in the golf cart and come up the steep deck stairs on her own. Soon, she was going out in the mornings with her buddies and stayed out playing for an hour or more before coming up the stairs and greeting us with a happy, tired dog grin and a muddy well used prosthesis.
Taylor even returned to her habit of jumping in her bed and asking for bedtime “backrubs”, a habit that I admit I spoiled her into expecting. After the dogs would come in from their last “go-out” of the night, they would all run to their beds for biscuits. Taylor would fly across the room on her prosthesis and jump and spin around on her bed. After receiving her biscuit, she would sit and look at me over her shoulder, asking for that “back rub” before she would lie down for the night.
The median survival rate for OSA is twelve months. In July of 2015, we celebrated the one year anniversary of Taylor’s cancer survival. She returned to CSU for a check and everything looked very good. I was sure we caught it early and given her the very best treatment possible. I was sure we had beaten this killer. I began to look toward the goal of Taylor turning 10 years old in April.
Then in August, Taylor began occasionally crying out in pain when rising from lying down. We instituted a multi-modal pain program and she did well for a while, but the occasional pain returned and seemed worse. She became slightly ataxic in her rear legs and started to lose tone in her right rear leg. Then the pain progressed both with lying down and rising. She stopped sleeping on her side and would only sleep on her sternum. Still, once up with her prosthesis on, Taylor was active, interactive and happy. She continued to seek us out often for love and attention although she was beginning to spend more and more time sleeping in her favorite spot on the deck, where she could overlook her property.
Then in the early morning hours of September 10th, she could not get comfortable. She got up to reposition to another bed and began to cry in pain. This cry was serious. Even with my wife’s help, she could not support herself; her hind legs simply would not work. I will never forget the way Taylor looked at me at that moment of trying to stand on her own and crying. Those eyes, that I had seen thousands of times when she would communicate love and affection, now looked at me and very clearly said, “This is going to be hard on you and hard for me, but you must now let me go.” It was as if she has spoken the words. And so, heartbroken, I did. After sedation, and with our words in her ears and our tears falling on her face, she passed in our arms.
No more pain Taylor. I cannot describe the huge hole she left in our home and our hearts. This had been a once in a lifetime dog-human relationship, and it was over. As I look back on the 14 ½ months of our fight against osteosarcoma, I wondered if I would do it all again. Would I put Taylor through two big surgeries, chemotherapy, the countless bandage changes and the struggles of learning to use her prosthesis? Yes, I would do it all over again. I would not take anything for those great extra months.
The term “human-animal bond” can’t really come close to describing the connection and love that develops between us and our wonderful pets. I am very grateful to have had an additional 14 ½ months with my Taylor Dane. I loved that dog deeply and she loved me and trusted me completely and without reserve. She had really good times in the months after diagnosis and her bad times were few and short. She required a great deal of our time, but we were happy to give it.
I am also very grateful to have had Taylor insured. With the many wonderful things we can accomplish with advances in veterinary medicine, pet health insurance is more important than ever. Having insurance on Taylor gave us options that we would not have been able to consider had she not been insured.
My experience is not unique. Canine cancer is one of the most common diagnoses I see in my practice; but each case is deeply personal. Each case of cancer potentially robs not only a dog’s life, but it painfully ruptures that wonderful bond we have with those dogs who have so deeply inserted themselves into our hearts.
Dr. Jim Humphries has been a veterinarian for 40 years and provides hospice and end of life care for pets in the Colorado Springs area. He has served in the US Army Veterinary Corps, and as the veterinarian at CBS News and CNN. He is a consultant for several veterinary pharmaceutical companies. In addition to practice, he also serves as a Visiting Professor at the College of Veterinary Medicine at Texas A&M University.